What is the purpose of a pelvic floor assessment?

In addition to a plethora of other interventions and assessments we will do, a hands on or off pelvic floor assessment is typically done during your evaluation. If you’re having pelvic floor symptoms, it is important to understand your muscle symmetry, strength, endurance, mobility, coordination, and tone. These 4 assessment options can help us learn more about what might be triggering your symptoms. Many people have heard or experienced that an “internal exam is the gold standard” for pelvic floor assessment. While it is a very helpful tool for gathering information and I aim to ensure you are comfortable and at ease during it - it is not the only option. The gold standard is the one that works for YOU and your nervous system. Any of these exams can be paused or stopped at anytime by request. During your first appointment, we will discuss these options to determine which one works best for you.

Option 1: Feedback-based assessment

This is the option that I use for all of my tele-health clients. In this assessment, you are fully dressed, and you are sitting on a small exercise ball or your hands to provide feedback on how your pelvic floor and core is moving. I will guide you to identify the various parts of your pelvic floor and core so you can be the detective to your body and observe how things are moving.

Option 2: Non-contact visual exam

In this option, you are undressed from the waist down and I am visually looking at your pelvic floor and the coordination of your muscles - no touch is involved in this option. You will have a sheet covering you for your comfort. We can use a mirror so you can see what I am seeing if you would like.

Option 3: External assessment

During an external assessment, you will be undressed from the waist down with a sheet covering you for comfort similar to the non-contact visual exam. The difference is that this option includes hands on assessment. I will first use a pelvis model to show you where I will be touching. Then, I will use a gloved finger to evaluate the pelvic floor muscles by checking for muscle activity, tenderness, and mobility to see what your muscles are doing on the outside. Unlike an exam at the OB/GYN, there are no stirrups, no awkward butt scoot, no speculum, and no pain.

Option 4: Internal exam

This is the one you may have heard about or experienced before. Again, unlike the OB/GYN there are no stirrups, speculum, or awkward butt scoot. This is the only option that involves internal touch. Like the external exam, I will demonstrate the process using a pelvis model first to allow you to more fully understand what we are assessing. I will use a single gloved and lubricated finger to touch the muscles beyond the outside to assess the three layers of the pelvic floor internally. Here, we are checking for tone, muscle contraction, relaxation, coordination. and trigger points.